Get Icmr Specimen Referral Form For Covid 19 Sars Cov2

Filling out the Icmr Specimen Referral Form for Covid-19 is an essential process for testing samples related to the virus. This comprehensive guide will walk you through each section of the form, ensuring you complete it accurately and efficiently.

Follow the steps to fill out the form correctly

1. Click ‘Get Form’ button to access the form and open it for completion.
2. Start with Section A – Patient Details. Fill in the mandatory fields such as patient name, age, and mobile number. Make sure to select whether the patient is in a quarantine facility and their gender.
3. In the sub-section A.1 - Test Initiation Details, indicate if a doctor’s prescription is available and if this is a follow-up sample. Attach the prescription if necessary.
4. Proceed to A.2 – Personal Details. Provide details such as current address, state of residence, and nationality. Ensure to include information related to the Aarogya Setu app.
5. In A.3 – Specimen Information, fill in the specimen type, collection date, and sample ID. Ensure these fields are marked with an asterisk are completed.
6. For A.4 - Patient Category, select only one option that best describes the patient’s situation from the provided categories.
7. Move to Section B - Medical Information. Start with B.1 – Clinical Symptoms and Signs. Indicate the symptoms experienced and the date of the first symptom onset.
8. Complete B.2 - Pre-existing Medical Conditions, specifying any chronic conditions.
9. If applicable, fill out B.3 - Hospitalization Details, including the hospital name and admission dates.
10. Lastly, in B.4 - Referring Doctor Details, provide the doctor’s name, mobile number, and email ID.
11. Once you have completed all fields, review for accuracy. You can then save changes, download, print, or share the completed form as needed.

Ensure you complete the Icmr Specimen Referral Form online to facilitate timely Covid-19 testing.